Rachel

You ask an interesting question.  It is widely estimated that 600 000 
children become infected with HIV every year, all but a few as a result of 
transmission from infected mothers. The rule of thumb is that, of those, 
one-third acquire the virus in utero, one-third during labour and birth, 
and one-third during breastfeeding - thus 200 000 would be estimated to 
acquire HIV through breastfeeding.

However, this figure may need to be questioned.   As we know, there is 
breastfeeding and there is breastfeeding. Anna Coutsoudis and colleagues in 
South Africa found that when babies were exclusively breastfed for 3 
months, there was NO increased risk of transmission at six months compared 
to babies who had been exclusively formula fed.  She found that what posed 
the major risk was not breastfeeding per se, but *mixed* breastfeeding with 
other foods and liquids.  A similar finding has recently been confirmed by 
researchers in Zimbabwe, who found that in the group of babies who were 
exclusively breastfed for three months, late postnatal transmission 
(attributable to breastfeeding) accounted for only 1%, 3% and 7% of 
transmission at 6, 12 and 18 months respectively - half the rate of mixed 
feeding.

To date there have been no studies published to show rates of transmission 
for babies exclusively breastfed for a full six months in accordance with 
up to date global recommendations, but the possibilties would seem to be 
promising.

Pamela Morrison IBCLC
Rustington, England
Co-coordinator, WABA Task Force on HIV and Infant Feeding

References:
Coutsoudis A, Pillay K, Spooner E, Kuhn L, Coovadia HM.  Influence of 
infant feeding patterns on early mother-to-child transmission of HIV-1 in 
Durban, South Africa:  a prospective cohort study. Lancet 1999;354:471-476.

Iliff PJ, Piwoz EG, Tavengwa NV et al, Early exclusive breastfeeding 
reduces the risk of postnatal HIV-1 transmission and increases HIV-free 
survival.
AIDS 2005, 19:699–708


At 16:06 22/10/2005, you wrote:
>The address is: http://www.nature.com/news/2005/051017/full/051017-17.html
><snip>
>
>In the article is the statement:
>"Every year, about 200,000 infants acquire the virus from their mother's
>milk, according to UNICEF, the United Nations children's fund. Between 10%
>and 20% of infants with HIV-positive mothers catch the virus after being
>breastfed for two years. "
>
>
>I've looked for where Unicef has stated this number of children "acquire
>the virus from their mother's milk", specifically excluding pregnancy and
>other transmission.  Can anyone give me an lead as to where it might be
>found?
>
>Rachel A. Miler RN, IBCLC

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